I recently gave a presentation at the Scottish Sports Dentistry Conference 2012, covering aspects of sports dentistry ranging from sporting injuries to performance mouthwear.
The title of my talk was 'Introduction to sports dentistry' and I looked at the prevalence of sporting injuries as far as the teeth are concerned, as well as basic treatment ideas and prevention of problems arising from sporting trauma. Quoting many papers, encompassing the very recent and those published up to 30 years ago, I talked about the prevalence of dental damage being sustained during sport. There is a significant amount of trauma to the head and neck involving the teeth and mouth. In the region of 20 per cent of head injuries involve the teeth and mouth.
I also talked about the various classifications of trauma and how to diagnose, manage and treat dental injuries. A large portion of the presentation looked at prevention, starting with early orthodontic intervention. If, for example, a child's teeth are very proclined, they are vulnerable to trauma. Often this is because they've been a thumb sucker. So you want to first encourage them to break the thumb sucking habit and then, through treatment, for example fixed or removable appliances, move the teeth back so that they're back behind the lower lip, which gives those otherwise vulnerable teeth a degree of protection.
Naturally, well constructed mouthwear is a significant method of preventing harm to the mouth and there are various appliances on the market. The ones people buy in the sports shops or ones you put in boiling water and self mould are not really protective, whereas the custom-made laminated mouthwear works extremely well.
However, there is a significant amount of literature that suggests that the wearing of even well constructed mouthguards has little beneficial effect.
The presentation included a look at modern, high-end performance mouthwear, which includes brands such as Under Armour Performance Mouthwear from Bite Tech. The key is that the laminated mouthwear has to be properly fitted and well-constructed. It's normally worn on the upper teeth, as most trauma is normally done to the upper teeth. However, it has indentations of the lower teeth in the biting surface, so there's a degree of protection for the lower teeth as well.
Mouthwear also gives a certain amount of protection to the bone because the teeth are biting together into the laminate, if you get a blow to the chin, you don't get the trauma to the temporomandibular joint (TMJ) that you would if the teeth were clenched tightly together. So it protects the teeth, it protects the bone supporting the teeth at the front of the mouth and it also protects the TMJ, which supports the jaw to the base of the skull.
Dental trauma is very common both in the sporting field and in general. I think people would be surprised to find out how frequently it happens. A recent study carried out amongst general dental practitioners who attended the sports dentistry programme at UCL Eastman Dental Institute, indicated the age group that were most at risk were 15-25 year-olds.
As with the UCL Eastman, I am a strong advocate for mouthwear, particularly for protection during contact sports. You should definitely wear it if you're involved in sport like hockey, rugby, lacrosse, basketball, volleyball, football or cricket.